In Billing
Oct 19th, 2018
A beginner’s guide to claims code editing logic. The U.S. healthcare system is highly complicated and extremely expensive. There are many layers between the provider of medical services and the payment for those services. This overly complex system leads to inefficiencies resulting in incorrectly paid claims and the need to spend even more time and ...
In Coding
Oct 12th, 2018
With the 2019 CPT® codebook still a few weeks away, we’re waiting to confirm an anticipated change: new guidelines that allow modifier 63 Procedure performed on infants less than 4 kgs with Medicine/Cardiovascular (90000-series) codes to described increased complexity of procedures performed on patients of less than 4kg. How to Use Modifier 63 When a surgeon ...
In Billing
Sep 28th, 2018
Health Management Associates, LLC (HMA), a hospital chain that has its headquarters in Naples, Florida will be paying over $260 million to avoid criminal and civil claims associated with a scheme to defraud the government of the United States. In this case, the government alleged that HMA was billing inpatient services when they should have ...
Become an expert in identifying, correcting, and preventing denials. Denied claims are as common and predictable as having a child spike a fever before a big holiday, and every practice or group finds itself wrestling with corrections and resubmissions. But if you ask AAPC’s Director of Curriculum Katherine Abel, CPC, CPB, CPMA, CPPM, CPC-I, AAPC ...
In Audit
Sep 14th, 2018
The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) has provided its latest, monthly Work Plan update. The Work Plan “sets forth various projects including OIG audits and evaluations that are underway or planned to be addressed during the fiscal year and beyond by OIG’s Office of Audit Services and ...